Vestibular Sense

When discussing Andrew's SPD, explaining how the vestibular sense is impaired, is usually something people have a hard time understanding. In part, because generally, when someone thinks about the senses, they think "five" and have often never even heard of the vestibular sense. In short, it is the sense that is input from the middle ear as it relates to movement, gravitational pull, and balance.

In Andrew, he is hypo-sensitive to movement. He doesn't register motion the same way as we do, so he likes motions that are BIG. It's one of the reasons he is constantly moving and runs everywhere he goes and loves his trampoline.

At therapy today, I took some video that demonstrates this hyposensitivity. (taken with my phone, so may not be the greatest) For most people, these motions would leave us unable to walk for several minutes, or at least unable to do so without falling down. Some people might even leave the exercise feeling nauseous. For Andrew, he LOVES it and usually begs for more, not feeling the effects of the movements. There are times when playing with Noah, that Andrew will spin and say he's dizzy and fall down. But, that is only because he is copying what others naturally do, or acting based on what he hears people say ("Aren't you getting dizzy doing that?")

In the second video, you can see his legs as he climbs out of the barrel and starts to walk away, completely unphased.

Spinning:



Spinning/rolling:

Play

I think it's pretty clear that "play" is the word written here. At OT this afternoon, Nikki had the dry erase board out for Andrew to list his foods for the day. They choose what order they're going to try the foods in and list them on the board. After completing the chosen number of bites (usually 4 "because I'm 4 years old"), Andrew gets to erase the food from the list.

5 foods on the list today and once done he got to go play. So, he told Nikki hey needed to write "play" on the list. And then he insisted he wanted to do it. Now, I know Andrew knows all of the letters on sight-- upper and lower case. But the only ones he's really written are the ones in his name-- Andrew. Needless to say, Nikki and I were both surprised when she dictated what letters to write and he wrote them all so clearly!!

I guess we'll be working on writing skills a bit more!

Hippotherapy, Session 7

It's cold at the barn this morning! If you look closely you can see he has a hat on under his riding helmet.

Multiple stations set up on the barrels for an activity.

Working.....

... to make a Jack-o-lantern!!

After finishing it, he used the pumpkin as a riding tool. Holding it over his head works his abs and challenges his balance.

Thanks for the ride, Ellie.

After riding, it was into the farmhouse for OT. Since he sees Ms. Nikki on Wednesdays also, she's able to spend more time working on the important areas. She does food work at the rehab center on Wednesdays, and with the Hippo sessions on Fridays, has been able to spend MORE time on food. So, on Fridays, after 30 minutes on horse & large motor skills, she focuses on fine motor skills in the house. It's really helped Andrew make big strides developmentally in a short amount of time and we are very fortunate to have an OT who is trained in both areas so we can have that carry-over.

Love the intense concentration as he works on his cutting skills.

This is what the cutting practice resulted in. Ms. Nikki cut out the pumpkin, Andrew cut out the facial features. Even though you can't really see his full face, you can tell he's excited & proud!

After cutting, he did more practice writing his name. He practiced each letter individually first, then put them all together. He had just a little help with a reminder of how to make the D but the rest was totally his own.

OT, Session 9

Ms. Nikki was working at a camp for kids who are on vents this week, so we saw Ms. Kristen again.  First up was some work on the swing.  Picking up clothespins, pinching them open, and clipping them to a strip of fabric-- while on hands & knees on the moving swing.

I mentioned I had tried him on a bike at the triplets yesterday, and he freaked out at being off the ground and having that "wobbly" sensation of the possibility of a fall (bike had training wheels, but you know how they kind of wobble back & forth from one to the other).  So, she took Andrew to the bike room and let him pick out a bicycle and helmet to try a ride in the hallway.  (a purple Disney princess helmet!  He was so excited because it has Belle on it and he loves Beauty and the Beast!)

He did not like the sensation.  And it was hard for him to coordinate the pedals while upright (he does okay on his trike, but is more laid back on it).  At one point, he collapsed on the handlebars in tears and frustration:

But, we continued encouraging and Ms. Kristen helped him get going.  He certainly didn't master it in the 10-15 minutes of riding, but he was no longer crying he didn't like it and wanted to get off.

Noah just thought it was great to run up & down the hallway and "pet" the dog that is painted on the walls in various spots.

After the bike, it was off to a room.  First was some work with what looked like plastic, kids chopsticks.  Andrew had to use them to pick up small foam shapes and put back in a container.  I need to get online and search for those sticks. (I asked and she said they got them from a catalog of therapy equipment) What great practice if he could use them to eat his chicken nuggets with at home!

Next he played in rice.  Practiced his writing strokes and then had to find a bunch of hidden animals.  Neat thing about the animals..... they linked together, so he got to link them all into a train.

Finally, snack time.  Applesauce, animal crackers and sour gummy worms, with the usual dipping.

I knew the worms were not going to go well.  He picked one once before as his take-home snack with Ms. Nikki.  He willingly tried it then, but did NOT like it and insisted on spitting it out.    But, not wanting to interfere or affect his choice/likings in any way, I said nothing today.  However, my jaw dropped when he stuffed an entire half a worm into his mouth at once, and I knew what was about to come....

Yeah.  That didn't go well.  He asked to spit it out and didn't touch any more of them.

OT, Session 8

Another week.  Another round at OT.  Ms. Nikki is gone for a couple of weeks, so Andrew saw a different therapist today... Ms. Kristen.  I wonder if she was worried about making sure she got everything in, because she gave Andrew a jam-packed session!

Instead of the usual big ball pit, Andrew chose the small ball tent to start in.  His willingness to get inside a pop-up tent is reassuring for our camping trip.

Then it was time for an obstacle course.  Over the swing:

Through the sensory tunnel.  3 different types of fabric.  The lump at the end of the blue section is Andrew's head:

10 jumps on the trampoline.  I think it was closer to 30 jumps for Andrew!

Under the swing:

And up the ladder.  This part was the most difficult since it challenged his balance and hit that sense/fear of falling that is always so bothersome for him:

After the obstacle course, he got to swing on the trapeze and drop onto the beanbag chair.  He had a hard time holding on long enough and would drop (fall?) off almost as soon as he started his swing.

Off to a room.  First up was Floam... weird, little beads that all stick together to be molded.  Kind of sticky. Bumpy. Odd texture.  There were plastic animals hidden inside that Andrew had to find and pull out.

Then some time writing on the dry erase board.  "French fries."

"Criss cross."

"Pancakes."  Remember, Andrew could not successfully draw a criss-cross or circle at his initial evaluation.  He's come a long way!

 

Doing the crab walk on the way back from the kitchen.

Finally, snack time.  Chocolate pudding and animal crackers, of course.  I forgot to mention to Ms. Kristen that he would most certainly pick those and does fine eating them, so she should steer him toward something else.  Oh well.  There's always next week!

OT, Session 7

First a "swim" in the ball pit:

Then a ride on the horse swing, while trying out the listening CD.  Nikki thinks listening therapy would greatly benefit Andrew, and we are fortunate to have a therapist friend at church who has the specialized headphones and cd's and let us borrow them.  We brought them to therapy with us so Nikki could monitor the first listening session and see how Andrew does with it.  He seemed to enjoy it, no adverse reactions, so we got the go ahead to continue with it at home. 2x/day for 30 minutes each time.  (building to that slowly, since getting Andrew to listen for a full 30 minutes is not likely to happen immediately)

Still with the headphones, he moved to the giant exercise ball.  Start on tummy, roll to back while partially hanging off side, pop a bubble with his free arm, then roll back up.  Andrew HATED this activity!  The sensation that he could fall was just too scary for him.  He cried and screamed and fought Nikki on it the whole time.  And while he cried, Mommy kept reminding herself it really is for his benefit in the long run.

He started out fine... before the rolling over part.

Nikki talking to and reassuring him.  They took the headphones off at this point so he would only have one thing to concentrate on.

Even with the reassurance, he was still very upset and uncooperative and quite happy when he heard Ms. Nikki say "Last one."

After that, we tried the beach ball.  Andrew had quite the adverse reaction to blowing up the swimming pool and the next day in the tub we had one of those "hockey puck" things that you put in the water and it expands into a washcloth.  As soon as it started getting bigger, Andrew freaked out and tried to jump out of the tub.  So, I thought it might be good to try something smaller.... still has the same noise as a big inflatable, still something that starts small and gets bigger... but doesn't get too big.  When we bought the beach ball at the store, he started crying and telling me he didn't want it and to put it back.  Got home, put it with the other stuff for therapy and left it sit there until today.  Nikki agreed it was a good idea, and was glad I brought it so he could see his reaction, so we opened it to blow up.  His reaction wasn't as severe, but he did get very anxious and ran to the door.  Nikki held him and reassured him it was okay, while I blew up the ball, and then he was excited to play catch with it.

After all of that work & stress, Andrew was happy to head to the kitchen to pick out snack for a picnic.  Trying the applesauce at home brought nothing but meltdowns and frustration all week, so Nikki let Andrew pick something-- chocolate pudding, of course-- and she picked applesauce.  He threw quite the fit about it with her, too, so at least she got to see some of what we deal with every time we try new foods.  He did eventually tolerate a little bit on his lips, but not without lots of crying & drama.

I would definitely say today was NOT was of his happier sessions.  All for the best, in the long run.  And I think it also shows that he is starting to feel more comfortable with Ms. Nikki and doesn't think he needs to always be on his best behavior & cooperative.  A good thing, since she can better help him when she sees what he is truly like.  She has an incredible amount of patience and I'm confident we have a good match in her with Andrew, which makes rough days like this one, a little easier to take.

OT Session 6

We seem to be settling into a routine with OT.  Large motor/physical activity, followed by fine motor, followed by food/tasting.  Andrew hasn't quite figured out the order of everything yet... but he does know that we head to the sensory room first.  That's where the ball pit is!

Today, he had to climb to the top of the bolster, using arm strength to pull himself up.  Once up, he could jump down to the edge of the ball pit and then in.  He is very fearful of anything that gives him a sense his balance is off and he could fall... so sitting on top of the bolster proved to be quite a challenge for him.

After his work on the bolster, we headed to the classroom.  Andrew got there via the "special green car."  To make it go, he had to push with his legs and pull with his arms at the same time.  He's still a little small for it, but after a few tries, he had it going pretty well!

Noah thought he should give it a try, too.

Andrew is getting pretty good at doing his criss-cross (+) and cicles, so today Ms. Nikki had him try following a path in a maze.  He had fun with it and got to do a couple... though he was asking to do even more!

A picnic snack.  Animal crackers to dip in pudding.  The crackers provide the crunch factor he likes, with the pudding adding a different texture & flavor.  Dipping the crackers also means he *might* get some on his fingers and experience the texture in that way as well.  (might-- he's quite the neat freak about it and very careful to keep his hands clean).  Today was butterscotch, which was new.  I think Andrew will eat most any flavor of pudding... it's the one thing of that texture he'll tolerate. 

Since he did so well with the crackers & pudding, Nikki suggested we continue with it at home, but try with applesauce.  After therapy, I had to go to Meijer for a few things, so we picked up some dinosaur crackers.  Andrew's choice-- he's really in to dinos lately-- so hopefully that means he'll be willing to eat some.

Session 5

A quick jump in the ball pit and then it was on the scooter board!  Andrew had to use his arms to pull himself down the hallway, collecting toys as he went and snapping them together:

After that, it was work on the bolster.  First, he had to start sitting, twist over onto his belly, use his arms to "walk" out for a fish, "walk" back and twist upright, then put the fish into the game.

After that, he sat on the bolster (straddle), had to twist to one side and use the opposite arm to pick up a fish from the floor, then back to sitting to put it in the game.

They practiced cutting (another skill that is greatly lacking), and since his crosses and circles are getting so good, moved on to drawing diagonal lines.  Then we went outside for a bit.  Andrew asked to put his shoes on, saying the sidewalk was hot (Ms. Nikki had her shoes off and said it was fine), but agreed to stand in the grass barefoot instead.  They did some sidewalk chalk drawing... including Andrew coloring the tops of his feet with it.  And then he got to visit the playground for a few minutes.  A couple trips down the slide and a trip across the monkey bars... with a lot of help on those!

Another good session!!!